The twentieth century saw serious scientific inquiry into addiction and addictive behaviors. The two main addiction models that sprang forth from the discourse are contradictory, and new theories are bringing us closer to a middle ground. These two models were the moral model and the disease model. In response to the pervading ides of sinful addicts, the 'disease of addiction' came about which removed the burden of blame from the substance user. However, as the field of addiction increases, more models have sprung forth as well as studies on their effectiveness. Following an overview of historical models, we will discuss the newest evolution of addiction modela.
In the 18th and early 19th centuries addiction was seen as a moral affliction, and that alcohol or drug users had poor character. These people were jailed or sent to mental hospitals with no real care. This moral failing was often strongly tied to sin, and they were considered spiritually fallen.
The 12-step model of treating addiction, as created and dispersed by Alcoholics Anonymous (AA) was founded in 1935 by Bill Wilson and Dr. Robert Smith. This was based on the disease model, stating that addicted people have no control over the substance and its addictive powers. A key part of the disease model is that it is irreversible, and because it cannot be cured, lifelong abstinence is necessary.
In the early 20th century Sigmund Freud was developing his theory, one that still informs modern psychology today, the concept that traumas from childhood go on to inform our adult decisions and coping mechanisms. Many clinicians use this theory in counseling to determine if present difficulties are predicated by childhood experiences.
For most of the 20th century, substance use was thought of as strictly a physical dependence and associated physical withdrawals. In the 1970s the narrative shifted to considering that a person's drug use was informed not just by the drug's physical effects but also by behavioral and societal factors, as well as the actual "high" of the drug. This model suggests dependence is a learned behavior, as well as a normal facet of human behavior which is only problematic when someone experiences negative consequences of their drug use yet continues to use,
A model that has gained traction in the last 20 years, it builds upon the social learning model by viewing society itself as a factor in making certain demographics more at risk for drug abuse Therefore, the solutions in this model are larger in scope and look at ways to alleviate poverty and discrimination, Drug rehabilitation and alcohol treatment in Canada has been heavily influenced by all these various models of addiction through the years
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